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Changes to a C-II: prescriber

Discussion in 'Pharmacy' started by akaykay, May 15, 2014.

  1. akaykay

    akaykay Rookie 10+ Year Member

    Medicare is rejecting C-IIs written by residents and patients getting discharged from the hospital are getting upset because the retails are sending them back to us requiring the attending to sign. Is there an exception to the rule of changing prescriber signature?? It's really inconvenient for the patient who was just hospitalized.
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  3. zelman

    zelman 7+ Year Member

    Nov 27, 2009
    Nope. I can't change a signature.
  4. npage148

    npage148 Senior Member PhD Pharmacist 10+ Year Member

    May 2, 2005
    I always make it abundantly clear to the patient it is the fault of the hospital and not us when they need to take a CS. Ours love to do 1-2 q6h prn disp:10day and they always have to go back to fix em
  5. Wheresmyaricept

    Wheresmyaricept 2+ Year Member

    Jun 15, 2011

    We cannot change the patient name, the drug prescribed, or the prescriber.
  6. sosoo

    sosoo 7+ Year Member

    Aug 10, 2009
    u think thats bad. medicare requires ppl wanting test strips to come to the store and sign a paper first. then come back days later to get it filled (per CVS). at least with CII they can still get it same day.
  7. owlegrad

    owlegrad Uncontrollable Sarcasm Machine Staff Member Administrator Pharmacist 7+ Year Member

    Not correct...
  8. genesis09

    genesis09 Senior Member 10+ Year Member

    Feb 27, 2006
    You can try putting in the dash part of the dea number if they are using the hospital's dea number.
  9. HouTX

    HouTX 5+ Year Member

    May 15, 2012
    we can not process hospital DEA for CS as is. we have to get supervising physician but in CII's case. have the attending sign them and we wouldn't have a problem. company's policy because their software can not take any extra digits (resident's ID) after hospital's DEA

    no exception, you can not change "name, name, name, date"
    name of pt
    name of drug
    name of prescriber
  10. zelman

    zelman 7+ Year Member

    Nov 27, 2009
    That's your state law. I believe in MA we can change anything but a signature.
    HouTX likes this.
  11. ohiopharmacist1

    ohiopharmacist1 2+ Year Member

    Jul 20, 2011
    This is the pharmacy's fault. I work at a hospital's outpatient pharmacy and this comes up a lot. Either play it safe and have your attending write it each time, have the patient fill at your hospital's outpatient pharmacy, or include the following instructions with your CII prescriptions:
    If you get a rejection saying that prescriber DEA not associated (or valid,etc) on a Medicare D claim, verify that the DEA and NPI are correct, then use one of the following submission clarification codes in sub clar field #1:

    42 - NPI is valid
    43- DEA is being renewed
    44 - DEA recently reactivated
    45 - DEA is a valid hospital-issued number with suffix
    45 is the most appropriate one for what you're talking about. Just make sure you put your hospital's DEA including your own personal suffix on the prescription. Hope that helps.
    LearnerSharer likes this.
  12. PlaceboFX15


    Jul 2, 2012
    In MA, we still cannot change the names of the patient, drug or prescriber.

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